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Biomedical subjects

G Licata

Publications and source records attributed to G Licata.

At least 19 recordsLinked to original sources
PubMed1992

Antihypertensive efficacy and effects of nitrendipine on cardiac and renal hemodynamics in mild to moderate hypertensive patients: randomized controlled trial versus hydrochlorothiazide.

In this study antihypertensive efficacy, safety, and the effects of short-term nitrendipine administration on central and renal hemodynamics were evaluated in mild to moderate hypertensives. Our final goal was to ascertain whether the reduction in blood pressure induced by nitrendipine treatment was associated with maintained renal function. After a run-in period with placebo, 26 hypertensives without cardiac or renal disease were randomly assigned to a double-blind 8-week controlled trial with nitrendipine (N) 20 mg once a day (13 pts) or hydrochlorothiazide (HCT) 25 mg once a day (13 pts). Renal hemodynamic measurements included effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) by radionuclide study using I-131 hippuran and Tc-99m, according to the methods described by Schlegel and Gates, respectively. Effective renal blood flow [ERBF = ERPF/(1-Ht)], filtration fraction (FF = GFR/ERPF), and renal vascular resistance (RVR = MBP x 80/ERBF) were also calculated. Other hemodynamic measurements included cardiac index (CI), left ventricular (LV) ejection fraction (EF), and total peripheral resistance (TPR) measured by the first-pass radionuclide angiography technique. At the end of N or HCT administration significant decreases (p less than 0.001) in SBP, DBP, and MBP vs. baseline values were observed in both hypertensive groups. In the N group a significant decrease (p less than 0.01) in TPR and RVR, and significant increases (p less than 0.05) in CI, ERPF, and ERBF were observed. In the HCT group a significant decrease (p less than 0.05) in RVR was found without significant changes in other hemodynamic parameters. No important side effects were observed with either therapy. In conclusion, nitrendipine was effective in reducting blood pressure in mild to moderate hypertensive patients and exerted favorable effects on cardiac and renal function.

Adult↗
PubMed1992

Left ventricular function response to exercise in normotensive obese subjects: influence of degree and duration of obesity.

This study has been designed to evaluate whether duration and severity of obesity can influence left ventricular function response to exercise in obese subjects without other known cardiovascular risk factors such as hypertension, diabetes or hyperlipoproteinemia. A total of 29 obese subjects were included and they were divided, according to their body mass index and to Garrow's criteria as follows: Overweight or mildly obese subjects: body mass index from 25 to 30 kg/m2; moderately obese subjects: body mass index > 30 and < 40 kg/m2. Both obese groups were further subdivided according to their duration of obesity evaluated by accurate anamnesis in subgroup A (duration of obesity less than 120 months) and subgroup B (duration of obesity more than 120 months). Left ventricular ejection fraction was detected by blood pool gated radionuclide angiocardiography both at rest and after symptom-limited bicycle ergometer procedure. At peak exercise left ventricular ejection fraction increased significantly (p < 0.05) only in overweight subjects. Exercise produced an increase of left ventricular ejection fraction in 14 overweight and in 5 moderately obese subjects and a decrease in 2 moderately obese subjects. At peak exercise mean heart rate and mean blood pressure increased significantly (p < 0.001) in both groups. When obese subjects were subgrouped according to duration of obesity, left ventricular ejection fraction increased significantly (p < 0.05) only in overweight subjects with duration of obesity less than 120 months. Duration of obesity correlated inversely with percent change in left ventricular ejection fraction (EF) at peak exercise (delta EF) (r = -0.59; p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Left ventricular diastolic and systolic function in normotensive obese subjects: influence of degree and duration of obesity.

The present study was carried out to evaluate systolic and diastolic parameters in overweight and moderately obese, but otherwise healthy subjects, and in a lean control group, to determine whether degree and duration of obesity can influence left ventricular function. A total of 27 subjects, 17 overweight or with moderate obesity and 10 lean, healthy subjects were included. Patients were divided into three groups according to their body mass index (BMI) and to Garrow's criteria as follows: lean control group (BMI less than 25 kg.m-2); overweight subjects (BMI from 25 to 30 kg.m-2); moderately obese subjects (BMI greater than 30 less than 40 kg.m-2). Systolic and diastolic parameters were measured using blood pool gated radionuclide angiography. Left ventricular (LV) ejection fraction (EF), peak ejection rate (PER), time to PER (tPER), peak filling rate (PFR) and time to PFR (tPFR) were evaluated. PER and PFR values were normalized for end-diastolic volume (EDV). EF and PFR were significantly lower (P less than 0.05) both in moderately obese and in overweight subjects and tPFR was significantly (P less than 0.05) prolonged in both groups in comparison to lean controls. Only in moderately obese subjects was PER significantly (P less than 0.05) decreased and tPER significantly (P less than 0.05) prolonged in comparison to lean controls. As compared to overweight individuals, moderately obese subjects were characterized by a significant decrease (P less than 0.05) in LVEF and PER and by a significant increase (P less than 0.05) in tPER, without relevant change in PFR and in tPFR.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1992

Rapid left ventricular filling in untreated hypertensive subjects with or without left ventricular hypertrophy.

In this study, independent contribution of age, HR, BMI, casual and ambulatory blood pressure, LVM and LVEF in evaluating diastolic filling have been investigated in 34 never-treated hypertensive patients and in 15 healthy normotensive subjects. All the subjects were free from coronary artery disease, valvular disease, heart failure, renal disease and psychiatric problems. All the hypertensive subjects (never treated) were subgrouped according to presence or absence of LVH. The PFR decreased significantly and tPFR increased significantly in hypertensive patients in comparison with normotensive subjects and they did not change in the presence vs absence of LVH. The PFR was inversely correlated with BMI, age, 24-h mean SBP and with 24-h DBP. In multiple regression analysis, PFR decreased with BMI, age, 24-h mean SBP and DBP but not with LVMI. These results suggest that BMI, age and 24-h mean blood pressure were the major determinants of PFR abnormalities in hypertensive patients.

Adult↗
PubMed1992

Captopril and glutathione before thrombolysis in acute myocardial infarction: a pilot study.

This study is aimed at checking whether treatment with glutathione (GL) and captopril (CA) before thrombolysis can further improve the protective effects of ACE-inhibitors in cases with anterior acute myocardial infarction (AMI). Ninety-eight double blind randomized patients (86 men and 12 women) showing symptoms of AMI anterior and undergoing thrombolytic treatment were admitted to our study and subdivided into 4 groups. Group A (25 pts) received thrombolytic treatment only, Group B (23 pts) received 3 g GL intravenously 15 min before thrombolysis and for 2 h thereafter, Group C (26 pts) received 6.25 mg CA orally 15 min before starting thrombolytic treatment, Group D (24 pts) received 3 g GL intravenously before thrombolysis and for 2 h thereafter, and captopril as well like group C. On the third day after AMI onset groups A and B received CA also. In all groups, the doses of CA were gradually increased according to blood pressure values. The following features were considered: a) the occurrence of early (within the first 2 h after thrombolysis) ventricular hyperkinetic arrhythmias; b) CK peak; c) the normalization time of CK peak (NT); d) the occurrence of late ventricular hyperkinetic arrhythmias (VHA) in the predischarge Holter test (Lown's class 2); e) ejection fraction (EF) being measured in 60 pts undergoing haemodynamic test. The results were an follows: Group A: VHA early 13/25, CK peak 1982 +/- 282; NT 71 +/- 2 h; Late VHA 8/25; EF 53.5 +/- 2.5% (16 pts). Group B: VHA early 11/23; CK peak 1917 +/- 242 U/l; NT 69 +/- 3 h; late VHA 7/23; EF 54.5 +/- 5.4% (14 pts). Group C: VHA early 4/26; CK peak 1671 +/- 266 U/l; NT 58 +/- 3 h; late VHA 5/26; EF 55.5 +/- 3% (16 pts). Group D: VHA early 3/24; CK peak 1463 +/- 201; NT 56 +/- 4 h; late VHA 5/24; EF 57.6 +/- 4% (14 pts).

Aged↗
PubMed1992

[Effect of captopril on human myocardial ACE-inhibition: neurohumoral variations during coronary sinus cardioplegia. Cardioprotective effect during aortocoronary bypass].

UNLABELLED: The present study is aimed at checking effects exerted by captopril on human myocardial ACE system (ACE-T) as well as the role played by tissue ACE-inhibition in reducing reperfusion damage. A human experimental model was used during cardioplegia due to aortocoronary bypass graft (CABG): 54 patients with coronary artery disease affecting 3 vessels having suffered from acute anterior myocardial infarction, homogeneous as far as ejection fraction (35-55%), number of grafts (3), clamping time, age and sex, were randomised in a double blind experiment, and were given captopril or placebo: 4 mg/l captopril were mixed into the cardioplegic solution with blood according to Buckberg, 8 blood samples were obtained from each patient and norepinephrine, epinephrine were assayed using an HPLC technique. Angiotensin 1 was assayed by RIA. CK was assayed as well (U/L). Blood samples were taken during CABG: pre-pump sample; pump sample; pump preclamping sample; coronary sinus sample; warm reperfusion sample; coronary sinus during warm reperfusion; after clamping sample; after cannulation. RESULTS: captopril group (29 patients): angiotensin 1:8.15; 6.9; 7.45; 8.66; 8.93; 8.70; 9.07; 9.40 versus placebo: 7.09; 7.43; 7.80; 9.31; 9.01; 8.35; 8.85; 8.07 mcg (all NS). Noradrenaline: captopril group: 359; 404; 329; 282; 263; 216; 310; 337 versus placebo: 439; 520; 499; 469; 526; 566; 501; 443 pg (p < 0.001). CK, captopril group: 79.9; 95.1; 100.8; 94.3; 104.2; 94.7; 108.4; 108 versus placebo: 76.2; 120.2; 135.5; 203; 225; 272; 247; 228.7 U/L (p < 0.01). Epinephrine values showed no significant difference between the 2 groups. Norepinephrine and CK decrease as well as angiotensin I increase in treated patients as compared to controls suggest some effect exerted by captopril ACE-T and its capability of reducing reperfusion damage and recommend its use for heart protection during CABG.

Aged↗
PubMed1992

[Captopril versus placebo in the prevention of hemicrania without aura. A randomized double-blind study].

Endogenous opioids are known to be involved in the pathophysiology of idiopathic headache. In fact, decreased levels of enkephalin (E) or endorphin (BE) during headache attacks might be a marker of an altered pain-inhibiting system of central neurotransmission or could be secondary to alterations of brain circulation that often occur during the headache crisis. Recently, captopril (C) has been shown to be apt to restore the availability of endogenous opioids, to improve cerebral blood flow via the inhibition of both the cerebral and systemic renin-angiotensin system or of catecholamine release. It has also been reported to be able to restore the nociceptive-antinociceptive balance through an increase of serum kinin (K) or prostaglandin (Pr) levels. In the present study, the efficacy of C in reducing the frequency (F), duration (D), or severity (S) of headache paroxysm were investigated in a double blind trial vs. placebo (P). Twenty-six subjects (5 males and 21 females; mean age 37 +/- 11 years) suffering from idiopathic headache at least for one year have been allocated to treatment with C (25 mg three times/day) or P according to a double-blind randomized protocol for 4 months. The effects of C or P have been evaluated with Migraine Index Correct, related to changes in F, D or S of headache attacks. Our results indicate that C is effective in reducing F, D or S in subjects with idiopathic headache.

Adult↗
PubMed1992

Therapeutic management of elderly hypertensives with concomitant ischaemic heart disease.

UNLABELLED: CHARACTERISTICS OF ELDERLY HYPERTENSIVES: Hypertension is most prevalent in older patients and is associated with increasing morbidity and mortality with age. Elderly hypertensives often suffer from concomitant diseases, such as ischaemic heart disease, caused by age-induced modifications to the cardiovascular system, haemodynamic function and neurohormone activity. THERAPEUTIC MANAGEMENT: Therapeutic management of elderly hypertensives with concomitant ischaemic heart disease must take account of the pharmacodynamic and pharmacokinetic changes that occur in older subjects and drugs should be selected for their efficacy in both diseases. Since elderly subjects often metabolize drugs more slowly, this population is particularly susceptible to drug-drug interactions and pharmacologically induced side effects. CHOICE OF DRUGS: The present review outlines the usefulness of diuretics, beta-blockers, angiotensin converting enzyme (ACE) inhibitors and calcium channel blockers in elderly hypertensives with ischaemic heart disease.

Aged↗
PubMed1992

Effects of captopril on the ACE-tissular system and on models of experimental ischaemia in isolated rabbit hearts.

In this study the authors evaluated the effect of captopril on coronary flow (CBF) dP/dT ratio and on reperfusion ventricular hyperkinetic arrhythmia (VHA) in 15 isolated and perfused (Langendorff's procedure) rabbit hearts following acute experimental ischaemia. The final goal was to determine whether pretreatment with captopril (administered before induced ischaemia or during the perfusion period) could protect the heart from the effects induced by acute ischaemia. Acute ischaemia was produced through 15-min ligation of the anterior descending coronary artery at its origin. After the ischaemic period, the hearts were subjected to a perfusion procedure for 45 min. Isolated hearts were connected to an intraventricular transducer system to evaluate intraventricular pressure curves, associated with a monitoring electrocardiogram system. Renin activity was detected by the RIA method from perfusion fluid samples. The 15 isolated and perfused rabbit hearts were subgrouped into 3 experimental groups as follows: Experiment No. 1: in this model the effects of acute induced ischaemia were evaluated in 5 rabbits without treatment and used as controls. At the end of the ischaemic period a relevant percent decrease in CBF (-36%) and in Dp/dT ratio (-33%) was found; after perfusion period a further percent decrease in CBF (-41%) and in Dp/dT ratio (-41%) was observed. Renin activity increased significantly only during the ischaemic period. In all the rabbits ventricular premature beats (VPB) were found and in 3 rabbits ventricular fibrillation (VF) was also detected.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Effect of heroin and morphine on cardiac performance in isolated and perfused rabbit heart: evaluation of cardiac haemodynamics, myocardial enzyme activity and ultrastructure features.

In the present study the effects of heroin and morphine administration on cardiac function, myocardial enzyme activity and cardiac ultrastructure features have been evaluated in isolated and perfused rabbit hearts. In 24 male rabbits the hearts were excised and immediately perfused in a retrograde non recirculating Langendorff apparatus. Successively, heroin 1 x 10(-5) or 1 x 10(-4) M or morphine at 1 x 10(-4) M were individually administered in 18 rabbits for 45 min. In 6 rabbits, used as controls, the isolated hearts were perfused with perfusion fluid for the same time. At the end of perfusion period the hearts were removed and histology was studied. During the perfusion period, creatine phosphokinase (CPK), lactic dehydrogenase (LDH) activity, heart rate (HR), derivative of intraventricular pressure time ratio (dP/dt) and changes in systolic ventricular pressure (SVP), diastolic ventricular pressure (DVP) and in coronary blood flow (CBF) were also evaluated. At the end of perfusion period no significant changes in CPK, LDH, HR, dP/dt ratio, SVP, DVP and CBF in comparison with basal values were observed in all groups. Histological specimen were characterized by slight derangements in atrial and ventricular structure both after heroin and after morphine administration. In conclusion our data suggest that alterations following opioids administration might rather be related to a systemic action involving only indirectly the heart.

Animals↗
PubMed1991

Effect of obesity on left ventricular function studied by radionuclide angiocardiography.

Several studies have shown a significant association of obesity with cardiovascular morbidity and mortality. The present study was carried out to investigate central and systemic haemodynamics in overweight and moderate obese, but otherwise healthy subjects, and in a lean control group to determine whether obesity can influence left ventricular performance per se. In this study an attempt has been made to eliminate misleading factors, such as diabetes, lipid abnormalities and hypertension. A total of 67 subjects, 44 with overweight or moderate obesity and 23 lean healthy subjects, were included. Patients were divided into three groups according to BMI levels and Garrow's criteria as follows: lean control group (BMI less than 25 kg/m2); overweight (BMI from 25 to 30 kg/m2); moderate obese (BMI greater than 30 less than 40 kg/m2). Overweight and moderate obese subjects were further subgrouped according to duration of obesity (DO) in subgroup A (DO less than 98 months) and in subgroup B (DO greater than 98 months). Haemodynamic assessment was performed using first pass radionuclide angiocardiography. When compared with lean subjects, overweight and moderate obese subjects were characterized by a significant increase in cardiac output (CO), stroke volume (SV), end diastolic volume (EDV), end systolic volume (ESV), total blood volume (TBV) and total plasma volume (TPV) and by a significant decrease in left ventricular ejection fraction (EF); some of these changes appeared to be related to the degree of obesity. In overweight and moderate obese subjects, total peripheral resistance (TPR) was lower than in lean controls, but this difference was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Hypertension in obese subjects: distinct hypertensive subgroup.

Obesity and hypertension are two closely associated conditions and obesity probably predisposes to hypertension. In this investigation we evaluated central, systemic haemodynamic and intravascular volume characteristics of 51 established hypertensive obese subjects subgrouped for degree of obesity. Subgrouping according to body mass index (BMI) was as follows: lean hypertensives, 17 subjects (BMI 23.00 +/- 0.45 Kg/m2); moderately obese, 19 subjects (BMI 26.92 +/- 0.30 Kg/m2); severely obese, 15 subjects (BMI 32.78 +/- 0.45 Kg/m2). Obese hypertensives were characterised by significantly increased cardiac output and total plasma volume (P less than 0.05) and by decreased total peripheral resistance (not significantly) and left ventricular ejection fraction (P less than 0.01). These changes appear to be related to the degree of obesity. Significant correlation coefficients between body mass index and cardiac output, total blood volume, total peripheral resistance and ejection fraction were also observed. In conclusion, established hypertension in the severely obese patient appears to be a separate haemodynamic entity.

Adult↗
PubMed1989

[Clinical and hemodynamic effects of medium-term ketanserin treatment in 2 compared groups of obese and non-obese hypertensive patients].

We evaluated systemic and central hemodynamics in 10 lean hypertensives and in 10 obese hypertensives (WHO stage I-II) after 8 weeks treatment regimen with a serotoninergic antagonist such as ketanserin. At the beginning and at the end of the study, body weight, BMI, blood pressure and heart rate were measured and a first pass radionuclide angiocardiography was performed to determine cardiac output, cardiac index and ejection fraction of left ventricle. Total peripheral resistances were also calculated. In both hypertensive groups ketanserin significantly reduced diastolic (p less than 0.05) and mean (p less than 0.005) blood pressure. No significant change in systolic blood pressure, cardiac output, cardiac index and ejection fraction of left ventricle has been observed in lean and obese hypertensives. Total peripheral resistance values significantly (p less than 0.05) decreased in lean hypertensives; in obese hypertensives total peripheral resistance moderately reduced. Our results indicated that monotherapy with ketanserin is effective in treating mild to moderate hypertension both in lean and in obese hypertensives and did not interfere with left ventricular performance. At last the effectiveness of ketanserin treatment appears moderately higher in lean than in obese hypertensives.

Adult↗
PubMed1989

Platelet function in hypo- and hyperthyroidism.

Alterations in cardiovascular hemodynamics are found in patients with hypofunction of the thyroid. Frank hypothyroidism favours the development of coronary heart disease. Platelets are thought to be important in atherosclerotic lesions initiation and progression. We studied platelet sensitivity to several agonists and to a physiological antagonist, prostacyclin, and thromboxane production in patients with hyperthyroidism and hypothyroidism. No statistically significant differences were found between platelets activities in patients and control subjects. We conclude that increased platelet function is not a direct indicator of susceptibility to cardiovascular diseases in patients with hypothyroidism whereas the hyperdynamic state, cardinal manifestation of thyrotoxicosis, is not associated with platelet activation.

Adult↗
PubMed1988

Effects of low doses of amiodarone on cardiac arrhythmias in patients with chronic ischaemic heart disease.

Continuous ECG monitoring is a useful method to evaluate the efficacy of antiarrhythmic drugs. The aim of our study was to evaluate the effects of amiodarone (400 mg day-1 for seven days and then 200 mg day-1, five days a week, for 60 days) in 20 patients with chronic ischaemic heart disease ascertained by stress test, thallium-201 myocardial scintigraphy and coronary angiography and with qualitatively and quantitatively similar cardiac arrhythmias in two continuous ECG monitoring sessions performed before starting treatment. All patients were previously on treatment with isosorbide 5-mononitrate (Is-5-Mn). Patients underwent two ECG monitoring sessions for 48 h, with an ICR instrument with two leads, first during pharmacological treatment with Is-5-Mn plus placebo and then after 60 days on treatment with Is-5-Mn and amiodarone. Heart rate decreased significantly with amiodarone (from 76.9 to 69.5 beats min-1) as did premature ventricular complexes (from 4686 to 329 day-1), ventricular couplets (from 154.3 to 5.0 day-1), ventricular tachycardia runs (from 91.7 to 0). ST segment depression more than 1.5 mm was present for 93.8 min day-1 on Is-5-Mn plus placebo, and was significantly less frequently observed (for 13.8 min day-1) on Is-5-Mn plus amiodarone. Finally, transient episodes of ischaemia, both symptomatic and asymptomatic, diminished on amiodarone from 22 to 9 day-1 in a significant way. In conclusion, amiodarone is a useful drug to obtain a reduction of ventricular arrhythmias and symptomatic and asymptomatic episodes of ischaemia in patients with ischaemic heart disease.

Aged↗
PubMed1987

Changes of angiotensin converting enzyme (ACE) levels during activation of the renin-angiotensin-aldosterone system (RAAs).

The aim of this study was to evaluate the changes of ACE levels during RAAs activation induced by: 1) a continuous graded bicycle ergometer test performed in a group of 15 males health youths aged between 21 and 30 years, with average age of 25.8 +/- 2.85 years; 2) i.m. injection of 20 mg of frusemide in 11 health youths (10 males and 1 female), aged between 20 and 30 years, with average age of 24.09 +/- 2.77 years; 3) dialytic treatment in 25 patients (12 males and 13 females), suffering from chronic renal failure, aged between 26 and 68 years, with average age of 54 +/- 15.42 years. Plasmatic renin activity (PRA), aldosterone (ALD) and ACE levels were determined by RIA in basal conditions and at peak of exercise in group 1, 15 minutes after i.m. injection of frusemide in group 2 and after a session of dialysis in group 3. In all the experimental conditions studied there was an activation of the renin-angiotensin system with significant increase of the PRA, ALD and ACE levels.

Adult↗
PubMed1987

An evaluation of the effects of isosorbide 5-mononitrate in patients with angina on effort using dynamic electrocardiography and echocardiography.

We studied 14 patients, 9 males and 5 females, with an average age of 53.6 +/- 9.2 years, having been suffering from effort angina for over 6 months, with positive ergometer test for angina and ST-segment depression greater than 1 mm. All the patients performed a washout period of 7 days at the end of which, before and after acute administration (90 min) of isosorbide 5-mononitrate or placebo some echocardiographic parameters were controlled according to a double-blind, randomized, crossover design. Moreover, after 2 months of open treatment with isosorbide 5-mononitrate (20 mg three times daily), echocardiographic parameters were investigated again. Continuous ECG monitoring (24 h) was performed after the washout period and after 2 months of treatment. After acute administration of isosorbide 5-mononitrate, we observed a reduction in pre- and afterload, whereas after 2 months of treatment the reduction in preload seems to play a more important role. Together with other mechanisms these haemodynamic changes are responsible for the substantial diminution of myocardial oxygen consumption, and consequently for the reduction of transient ischaemic episodes, both symptomatic and asymptomatic with heart rate increase. These results suggest that isosorbide 5-mononitrate exhibits a definite nitrate-typical vascular activity that is evident both after single administration and after 2 months of treatment.

Angina Pectoris↗